A 22-year-old woman comes to the emergency department because of daily headaches for 3 weeks. Yesterday, the patient had blurry vision in both eyes and a brief episode of double vision. She has been taking ibuprofen with only mild improvement of her symptoms. She has not had any trauma, weakness, or changes in sensation. Medical history is remarkable facial acne for which she takes vitamin A and obesity but no other chronic conditions. Brain imaging is normal, and blood cell counts and serum chemistry studies are within normal limits. Lumbar puncture reveals elevated opening pressure, and idiopathic intracranial hypertension is diagnosed. Weight loss is advised, and the patient is prescribed acetazolamide therapy. Which of the following changes are most likely to occur in this patient over the next several days due to the medication?

Question

A 22-year-old woman comes to the emergency department because of daily headaches for 3 weeks. Yesterday, the patient had blurry vision in both eyes and a brief episode of double vision. She has been taking ibuprofen with only mild improvement of her symptoms. She has not had any trauma, weakness, or changes in sensation. Medical history is remarkable facial acne for which she takes vitamin A and obesity but no other chronic conditions. Brain imaging is normal, and blood cell counts and serum chemistry studies are within normal limits. Lumbar puncture reveals elevated opening pressure, and idiopathic intracranial hypertension is diagnosed.  Weight loss is advised, and the patient is prescribed acetazolamide therapy.  Which of the following changes are most likely to occur in this patient over the next several days due to the medication?

Quizplus · Accepted Answer

Eductional Objective: Acetazolamide is a first-line pharmacotherapy for patients with confirmed idiopathic intracranial hypertension IIH. it inhibits Carbonic anhydrase enzyme that block reabsorption of sodium bicarbonate (NaHCO₃) in the proximal tubule. The main effect is increased HCO₃- excretion, leading to increased urine pH, mild metabolic acidosis (with compensatory respiratory alkalosis), and mild hypokalemia.

A 22-Year-Old Woman Comes to the Emergency Department Because of Daily